House Speaker Nancy Pelosi on Wednesday floated the idea of a two-track plan for health care reform — with Congress pursuing easier-to-pass incremental changes now and comprehensive reform later.

“We believe that it’s possible to have comprehensive health care reform as we go forward, but at the same time, it can be on another track where some things can just be passed outside of that legislation, and we’ll be doing both,” Pelosi said in an interview with POLITICO.

Though the Democrats’ loss of Ted Kennedy’s old Senate seat has complicated efforts to get the 60 votes they need for a sweeping health care bill, Pelosi insisted that comprehensive reform is still on the agenda.

“We have to get it done,” the speaker said. “What the process is doesn’t matter. The outcome is what is important, and what it means to working families in America.”

Asked whether piecemeal changes could come before comprehensive reform, Pelosi said: “Some may. It just depends on how long it takes for the comprehensive to go. But it doesn’t mean that the comprehensive isn’t moving. It is essential. If everyone loved their health insurance in the country — and you know they don’t — we would still have to do this for financial reasons.”

The two prongs in Pelosi's strategy aren't mutually exclusive; party leaders have no plans to abandon their push for a sweeping health care bill, aides said Wednesday, but the speaker would like to move items that are popular with her members - and wouldn't qualify under fast-track rules that require a simple 51-vote majority in the Senate.

With health care at a standstill, House Democrats are already preparing to force a floor vote on one of the provisions most targeted to the insurance industry - a repeal of a 1945 antitrust exemption which critics contend has allowed the companies to collude in the marketplace. The provision is widely popular among House Democrats and even has support in the Senate.

The precise timing is not yet resolved, but the idea would be to essentially pull out that section of the House-passed health care bill and bring it to the floor as stand-alone legislation in the next two weeks, people familiar said. Apart from the politics of forcing an anti-industry vote, the strategy also serves Pelosi’s purposes since the anti-trust language is not something that would survive in any case if Democrats were to ultimately use Senate “fast-track” reconciliation rules to break the impasse on comprehensive reform.

The speaker has offered this idea in closed-door caucus meetings in the wake of the Massachusetts special election, sources said.

In Wednesday’s interview, Pelosi reiterated that ramming the existing Senate bill through the House is not an option.

“There is no support in my caucus in the present form, at this time, for the Senate bill,” she said. “I don’t see that as an option. But I do think that we’re in range to make some improvements in it that will make it more affordable for the middle class, which is essential. Hold the insurance companies more accountable. Those two things are essential to us.”